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Aboriginal Australians experience substantial housing disadvantage on a range of measures, yet relatively little is known about how urban Aboriginal people perceive their housing circumstances. While most Aboriginal people live in urban or suburban areas, research and policy attention has tended to focus on remote housing issues. This paper draws on focus groups conducted with Aboriginal people at an Aboriginal Medical Service in Western Sydney (n = 38) about their housing experiences and beliefs about why many Aboriginal people experience the housing disadvantage they described. Participants described a landscape in which their housing experiences were materially affected by their Aboriginality and inextricably linked to racial discrimination, poverty, marginalization, the lack of social and affordable housing and disempowerment, all with negative implications for their psychosocial well-being. Participant views aligned with critical race theory, with race described as a fundamental structural force that created and deepened housing disadvantage beyond economic hardship alone. [ABSTRACT FROM AUTHOR]

Background: Housing is a key determinant of the poor health of Aboriginal Australians. Most Aboriginal people live in cities and large towns, yet research into housing conditions has largely focused on those living in remote areas. This paper measures the prevalence of housing problems amongst participants in a study of urban Aboriginal families in New South Wales, Australia, and examines the relationship between tenure type and exposure to housing problems.Methods: Cross-sectional survey data was provided by 600 caregivers of 1406 Aboriginal children aged 0-17 years participating in Phase One of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Regression modelling of the associations between tenure type (own/mortgage, private rental or social housing) and housing problems was conducted, adjusting for sociodemographic factors.Results: The majority (60%) of SEARCH households lived in social housing, 21% rented privately and 19% either owned their home outright or were paying a mortgage ("owned"). Housing problems were common, particularly structural problems, damp and mildew, vermin, crowding and unaffordability. Physical dwelling problems were most prevalent for those living in social housing, who were more likely to report three or more physical dwelling problems than those in owned (PR 3.19, 95%CI 1.97, 5.73) or privately rented homes (PR 1.49, 1.11, 2.08). However, those in social housing were the least likely to report affordability problems. Those in private rental moved home most frequently; children in private rental were more than three times as likely to have lived in four or more homes since birth than those in owned homes (PR 3.19, 95%CI 1.97, 5.73). Those in social housing were almost half as likely as those in private rental to have lived in four or more homes since birth (PR 0.56, 95%CI 0.14, 0.77). Crowding did not vary significantly by tenure type.Conclusions: The high prevalence of housing problems amongst study participants suggests that urban Aboriginal housing requires further attention as part of efforts to reduce the social and health disadvantage experienced by Aboriginal Australians. Particular attention should be directed to the needs of those renting in the private and social housing sectors, who are experiencing the poorest dwelling conditions. [ABSTRACT FROM AUTHOR]

Aim: To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas.Methods: Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS. Interviews took place at four Aboriginal Community Controlled Health Services in metropolitan Australia or by telephone. Interview transcripts were analysed thematically.Results: We identified five major themes: leveraging partnerships (building on collaborative research, integrating and expanding existing networks, engaging the Aboriginal community), intrinsic and extrinsic motivation (seizing opportunities for altruism, empowered by collegiality, taking pride in achievements), removing common barriers (circumventing waiting times and cost, providing culturally appropriate services, raising awareness), strategic service delivery (proactive service delivery, encouraging flexibility and innovation, offering convenience and support), and service shortfall (pressured timeframes, desire for more sustainable services).Conclusion: HEALS facilitated improved health-care access by providing prompt, no-cost services that were strategically targeted to address multiple barriers. HEALS' model of care was built upon strong pre-existing research partnerships, the knowledge and support of five Aboriginal Community Controlled Health Services, and the willingness and motivation of local health-care professionals to help Close the Gap. HEALS highlights the importance of tailoring health services to the needs of Aboriginal families, and provides a framework for other health service delivery initiatives. [ABSTRACT FROM AUTHOR]

Background: Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health.Methods: Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10.Results: Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children.Conclusions: Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians. [ABSTRACT FROM AUTHOR]

Background: Proximity to public open space, such as parks and other green spaces, has considerable health benefits, and people have been shown to be more likely to use such space for physical activity if it is of high quality. This paper describes a new remote-assessment approach that makes use of Google Earth Pro (the free version of this program is Google Earth) to provide rapid and inexpensive measurement of the quality of public open space. Purpose: The aim of the study was to assess the correlation between assessments of the quality of public open space using (1) the remote method (making use of Google Earth Pro) and (2) direct observation with a well-established measure of quality, the Public Open Space Tool (POST). Methods: Fifty parks selected from the southwest part of Sydney, Australia, were assessed in 2009 with the remote method (using Google Earth Pro), and scores were compared with those obtained from direct observation of the same parks using POST. The time taken to conduct the assessments using each method was also recorded. Raters for each method were blind to scores obtained from using the other method. Analyses were conducted in 2009. Results: The Spearman correlation coefficient between the quality scores obtained for the 50 parks using the remote method and direct observation was 0.9 (p<0.0001). The remote method took 4 hours, whereas direct observation took 42 hours, showing the remote method to be much faster and more resource efficient for the measurement of the quality of physical activity–related environments. Conclusions: The remote-assessment method provides, for the first time, the capacity to assess the quality of large numbers of parks and other green spaces without the need for in-person visits, dramatically reducing the time required for environmental audits of public open space. [ABSTRACT FROM AUTHOR]

Objective: To quantify absolute cardiovascular disease (CVD) risk in Aboriginal and Torres Strait Islander people and their use of lipid-lowering therapies., Design, Participants: Cross-sectional analysis of nationally representative data from 2820 participants aged 18-74 years who provided biomedical data for the National Aboriginal and Torres Strait Islander Health Measures Survey component of the 2012-13 Australian Aboriginal and Torres Strait Islander Health Survey., Main Outcome Measures: Prior CVD and use of lipid-lowering medications were ascertained at interview. 5-year absolute risk of a primary CVD event was calculated with the Australian National Vascular Disease Prevention Alliance algorithm, with categories low (< 10%), moderate (10-15%) and high risk (> 15%)., Results: Among participants aged 35-74 years, 9.6% (95% CI, 7.2-12.0%) had prior CVD; 15.7% (95% CI, 13.0-18.3%) were at high, 4.9% (95% CI, 3.3-6.6%) at moderate, and 69.8% (95% CI, 66.8-72.8%) at low absolute primary CVD risk. 82.6% of those at high primary risk were identified on the basis of clinical criteria. High primary absolute risk affected 1.1% (95% CI, 0.0-2.5%) of 18-24-year-olds, 4.7% (95% CI, 2.0-7.5%) of 25-34-year-olds, and 44.2% (95% CI, 33.1-55.3%) of 65-74-year-olds. Lipid-lowering therapy was being used by 52.9% (95% CI, 38.2-67.6%) of people aged 35-74 years with prior CVD and by 42.2% (95% CI, 30.5-53.8%) of those at high primary CVD risk., Conclusion: Absolute CVD risk is high among Aboriginal and Torres Strait Islander people, and most of those at high risk are undertreated. Substantial proportions of people under 35 years of age are at high risk, but are not targeted by current guidelines for absolute CVD risk assessment, compromising CVD prevention in this population.